Integrating Intimate Partner Violence Assessment and Intervention into Healthcare in the United States: A Systems Approach

Miller, Elizabeth; McCaw, Brigid; Humphreys, Betsy L.; Mitchell, Connie

doi:10.1089/jwh.2014.4870

Cited by 152 publications

(123 citation statements)

References 62 publications

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“…88 In addition to absent or poorly implemented guidelines for providers, barriers to IPV screening can include overburdened staff, lack of private screening space, lack of reimbursement for services, and lack of adequate staff training. 89,90 There is a strong need to develop clinical protocols and provider education regarding PrEP and the intersection of HIV and IPV, as well as clinic policies that enable IPV screening provision during HIV counseling and testing.…”

Section: Implications For Clinical Practicementioning

confidence: 99%

The Potential of Pre-Exposure Prophylaxis for Women in Violent Relationships

Braksmajer

Senn

McMahon

2016

AIDS Patient Care and STDs

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HIV and intimate partner violence (IPV) are significant intersecting threats to women's health. Women in violent relationships have few feasible HIV risk reduction options as traditional prevention methods are largely dependent on a partner's cooperation. The purpose of this review is to explore potential benefits and drawbacks of pre-exposure prophylaxis (PrEP) use among women in the United States experiencing IPV. Advantages of PrEP use in this population include the potential for covert or autonomous use, coital independence, dual protection against sexual and injection risk, and facilitated connections to social services. A number of barriers, however, may interfere with the effective use of PrEP, including partner resistance, cost, frequent medical visits, gendered norms regarding sexuality, and stigma. To realize its potential for women in violent relationships, it will be necessary to incorporate PrEP into behavioral and structural interventions that encourage uptake, facilitate adherence, ensure women's safety, and challenge existing gender norms.

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Section: Implications For Clinical Practicementioning

confidence: 99%

The Potential of Pre-Exposure Prophylaxis for Women in Violent Relationships

Braksmajer

Senn

McMahon

2016

AIDS Patient Care and STDs

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“…15 The passage of the Affordable Care Act in 2010 gave new weight to these calls with its emphasis on disease prevention and health promotion through screening 1 U.S.…”

Section: Screening and Counseling For Ipv: A Visionmentioning

confidence: 99%

“…Because disclosure of IPV can occur in multiple ways 15 and a positive IPV screen (or suspected case) can require a range of responses, the protocol should provide a portfolio of evidence-based recommendations for clinical action that are relevant and actionable within the particular healthcare setting. Examples might include clinical requirements for contacting authorities in the case of imminent danger, options for selecting a community-based service provider and points of contact to facilitate the warm referral, or recommendations (and requirements) for inquiring about the health and safety of dependents who may be IPV-or trauma-exposed.…”

Section: Operations and Culturementioning

confidence: 99%

“…23,34 These challenges are compounded by the fact that the process of screening and identifying individuals who have experienced (or are at risk for) IPV can vary with each patient and is frequently complicated by legal, safety, and privacy considerations as well as victim-perpetrator, 15 victim-provider, and even setting-specific dynamics. As a result, researchers and advocates have concluded that systems-level strategies are needed to help health care practices craft and implement systematic approaches to improve identification of and support for IPV-exposed girls and women consistent with our vision described above.…”

Section: Systems-level Facilitatorsmentioning

confidence: 99%

“…Fourth, additional work is needed pertaining to the safe, smart and appropriate use of technology to increase screening and follow-up. As discussed by Miller et al in this special issue, 15 electronic health records (EHRs) hold tremendous potential for the implementation of universal screening and improved follow-up with IPV-suspected or IPV-exposed individuals. While EHRs have already shown to be capable of increasing IPV screening and documentation, 35 significant work is needed to test and validate EHR-based screening tools and algorithms for interventions in a variety of healthcare settings with diverse patient populations.…”

Section: Systems-level Facilitatorsmentioning

confidence: 99%

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Screening and Counseling for Intimate Partner Violence: A Vision for the Future

Ghandour

Campbell

Lloyd

2015

Journal of Women's Health

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We describe a vision of screening and intervention for Intimate Partner Violence informed by deliberations during the December 2013 Intimate Partner Violence Screening and Counseling Research Symposium and the resultant manuscripts featured in this special issue of the Journal of Women's Health. Our vision includes universal screening and intervention, when indicated, which occurs routinely as part of comprehensive physical and behavioral health services that are both patient centered and trauma informed. Areas for future research needed to realize this vision are discussed. 2 The evidence showing a substantial prevalence of IPV among women, both lifetime and recent, is clear, 2,3,4 as is the evidence that both current and past IPV are associated with immediate and long-term physical and mental health problems. [5][6][7] Tools to screen for IPV have been validated 3,8 and at least one has been formulated as an ''app'' (R3 app containing HITS*) 9 for easy use by clinicians. There is also considerable evidence supporting the efficacy of interventions for IPV in both community and health care settings as well as promising new electronic intervention strategies. 10Routine screening for IPV is supported by evidence, reflected in policy briefs by professional associations, 11,12 and endorsed by both abused and non-abused women in population-based and setting-specific studies. 4In response, the United States Department of Health and Human Services (DHHS) has supported programmatic activities designed to increase IPV prevention, improve services to those affected, and better understand the nature, extent, and sequelae of current and lifetime exposure to IPV.13 Within the context of these ongoing investments, and bolstered by the Affordable Care Act's commitment to preventive services for women, 14 including IPV screening and counseling, the DHHS Coordinating Committee for Women's Health convened the Intimate Partner Violence Screening and Counseling Research Symposium on December 9, 2013. 13 The goal of the Symposium was to identify research gaps related to IPV screening and counseling in primary healthcare settings and to identify and inform future research priorities to address these gaps, with the ultimate goal of informing guidelines, services and practice.1,13 The meeting demonstrated both the power and the possibility of a multi-agency, multi-sector approach to shaping, building, and strengthening the evidence base for IPV screening and intervention. Building on this foundation, the goals of this paper are twofold: (1) to describe a vision for the effective implementation of evidence-based IPV screening, assessment and intervention strategies based on the research featured in this special issue; and (2) to highlight specific research gaps that must be filled in order to realize that vision. Screening and Counseling for IPV: A VisionAdvocates and practitioners have long called for the implementation of effective IPV screening and intervention in healthcare settings. 15 The passage of the Affordable Care A...

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